NHS Activity Tracker: July 2025

On the second Thursday of the month, NHS England publish data relating to demand, activity, waiting times and national performance against constitutional standards and recovery targets across the secondary care sector. Each month, we'll take a more detailed look at national and trust level data across the acute, ambulance, community and mental health sectors.

This month’s data release highlights the ongoing strain across sectors, with record levels of activity and variable improvements against performance ambitions. Urgent and emergency care (UEC), elective treatment, and mental health all faced significant demand, while some areas showed signs of recovery. 

 

Progress in key areas 

Despite sustained demand, there has been measurable progress across several areas. June saw a stronger performance against the four-hour A&E target than the last three years despite demand being higher this year. This highlights ongoing improvements being delivered by trusts, which are needed to meet the 78% target by the end of winter, as set out in the UEC plan. Discharge delays and 12-hour A&E waits continue to decline, suggesting a gradual improvement in patient flow. Ambulance services continued to meet the category 2 response time target for the fourth consecutive month, and handover delays improved to the fastest time since August 2024.  

Across planned care, cancer activity remains high across all pathways. Diagnostic testing activity hit a record high for May, and the elective waiting list fell to its lowest figure in over two years.

In mental health and community services, there are signs of progress too, with wait times for adults and children that accessed NHS funded mental health services in the last three months falling, and the community services waiting list coming down for the first time this year. 

 

Demand shows no signs of slowing

All sectors continue to manage consistently high levels of demand. In UEC care, A&E attendances reached the busiest June on record, while ambulance incident volumes were the second highest ever recorded for this time of year. In elective care, patient demand for diagnostic testing still exceeds capacity. This has resulted in a diagnostic waiting list diverging in trend from the main elective waiting list and performance continuing to slip back against key targets. In mental health, new referrals increased in May, with open referrals reaching their highest May figure on record.

 

Ongoing strain on capacity and performance 

Capacity remains stretched, and performance against some targets has stagnated. For example, the 28-day faster diagnosis standard slipped back slightly for the third month in a row, and diagnostic performance moved further away from the constitutional standard of 99% of cases to be seen within six weeks. Long waits (of over 52 weeks) for community services continue to grow, driven by sustained increases in demand and ongoing capacity constraints. In mental health, demand remains elevated, with open referrals for children and young people (CYP) rising and a record high number of CYP accessing services. 

 

Looking ahead 

The 10-year health plan, published in July 2025, sets out a bold vision for reform. It calls for a shift from hospital to community care, analogue to digital systems, and reactive treatment to prevention. However, clarity is still needed on how this will be delivered and what trade-offs may be necessary when financial constraints limit progress toward operational targets.  

As our on the day briefing outlines, the plan must now be matched by clear delivery mechanisms and adequate resourcing. With winter planning already underway, the coming months will test the system’s ability to translate ambition into action, and this will be intensified by the impacts from industrial action.